On Buying Health Insurance

There are more choices than there are distinctions. It’s impossible to see what’s different between various policies without being a statistician and actuary. I’m pretty math savvy and my head is swimming!

In the past we depended on insurance to help beginning with dollar one. Now, I’m wondering how important ‘dollar one’ really is.

obamacareSince I left FoxCT I have been insured through COBRA, the Consolidated Omnibus Budget Reconciliation Act. All that means is no employer subsidy. I’m paying 100%.

Insurance is expensive. You probably already knew that.

Eighteen months have passed. I’m forced to get coverage on my own. This is among the most confusing things I’ve ever done!

First the good news. Under the Affordable Care Act, aka Obamacare, I can buy insurance! How that would have worked out before, considering my back surgery two summers ago and my age? All I know is, I’m insurable.

My beef with Obamacare is it doesn’t go far enough. Why do we bother with private insurance? Why must we confuse everyone? The rest of the world seems to prefer a single payer system. Seniors seem happy with Medicare.

There are too many choices.

Let me refine that. There are more choices than there are distinctions. It’s impossible to see what’s different between various policies without being a statistician or actuary. I’m pretty math savvy and my head is swimming!

In the past we depended on insurance to help beginning with dollar one. Now, I’m wondering how important ‘dollar one’ really is. Are we better off ‘self insuring’ for common medical problems and letting insurance kick in at big dollar amounts? How much out-of-pocket can I take?

Within the next day or two we will reach a decision. I wish it was a more educated decision.

The Modern Diagnosis

Steffie had a pretty bad allergic reaction this weekend. It wasn’t fun for her, or for us. Your child can grow up – but she’s still your child.

As the week went on, the allergic reaction went away. That’s good.

Our family physician said Steffie should see an allergist. I called the to make an appointment with the allergist I see… or anyone in his practice. June – the earliest available appointment is June!

Popular folks these allergists.

I wasn’t sure what to do, so I sent my allergist an email, with a photo of Steffie taken while she was in the midst of the reaction. He took a look and wrote back.

His response suggested what we were already doing was right, and it wouldn’t be necessary to see him until or unless there were more problems.

I’m glad he wrote back, but this is a hell of an imposition on my part, isn’t it? Maybe it’s time to acknowledge the new era and have our insurance companies (or, shudder, me the patient) pay for this service.

As far as I can tell, when my internist or allergist gives me advice from his keyboard, he’s doing this out of the goodness of his heart – literally giving away the work he usually charges for.

My guess is, in some cases, Internet consultation is a good thing. From an insurance standpoint, isn’t this a chance to purchase a more cost effective service for their customers? Shouldn’t the physician be compensated to encourage this?

I am not a doctor (nor do I play one on television&#185). I’m sure those I know will tell me if I’m off base here.

&#185 – That line, “I’m not a doctor, but I play one on television,” was actually used in a TV commercial about 40 years ago.

Blogger’s addendum: And, my primary physician did respond:

If there were something that were more than 100%, I’d agree with you that much. Does the accountant or lawyer or guy at the gas pump EVER give it away for free? I think that our ethic and culture is different, though. Medicine is rightly called a “caring profession.” and when we care, we really do care. So we do it, without listening for the sound of the cash register ringing.

And don’t hold your breath waiting to hear that Aetna or Anthem or, God forbid, Medicare will ever pay me or your allergist for giving you email or even telephone advice. Not in my lifetime, and I plan to torture all of you for many years to come.

My Parents’ Medical Care – Not Well

My sister popped up on IM tonight. I couldn’t hear her voice, but I could sense she was upset. I’m not sure how that works in a few short typed words, but I knew. I picked up the phone and gave her a call.

She had spoken to our folks earlier in the evening and was upset. By the end of the call I was upset too.

Their doctor… their internist… had decided to affiliate with a program called MDVIP. Basically, in order to stay patients of his they would have to pony up $1,500 per year each.

The $1,500 would buy them an examination and wellness program. The bottom line is, they would receive similar care, still paying for each visit under Medicare, at an additional cost of $3,000.

The physician said this would allow him to limit his practice to 600 patients. Well yeah! Because his end of the $1,500 is $1,000 ($500 to MDVIP). Six hundred patients is $600,000 per year, plus whatever he charges to be a physician.

My blood is boiling because I consider this medical extortion. To me (though probably not to our legal system) this plan allows doctors to charge more than they are allowed to charge under Medicare.

Maybe I’m too naive – a babe in the woods. Grow up! Get with the program, Geoff.

A few years ago, Senator Bill Nelson of Florida got involved.

Nelson has introduced legislation in the Senate, S. 1606, that would prohibit doctors who charge access fees from also billing Medicare for their services. “If this practice continues to spread, it could mean the end of Medicare,” Nelson said. His legislation doesn’t address people covered by private health insurance. It would be up to the insurer whether to allow doctors in its network to charge consumers such fees.

The fact, three years later, my folk’s doctor is doing this, says Nelson failed.

Maybe I’m missing something? I dropped a note to my doctor/friend, Steve. No answer yet, but I’m anxious to get his read on this. After all, he’s on the other side of the stethoscope.